Healthcare Core Curriculum
Competency #4: Managing Conflict
Dede Carr, BS, LDA
Karen Neu, MSN, CNE, CNP
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2
Objective
Describe the communication skills that are important
when managing conflict
“…Peace is not the absence of conflict but the
presence of creative alternatives fro responding to
conflict—alternative to passive or aggressive
responses, alternatives to violence”
Dorothy Thompson
“The inability to share….
to communicate – that’s the biggest
problem in the world…
that’s how people get themselves in
all these troubles”
V. Satir
“Consequence of real or perceived differences in mutually
exclusive goals, values, ideas, attitudes, beliefs, feelings, or
actions” (Sullivan & Decker, p. 185)
 Conflict is common & important part of the change process
 Is natural & normal part of life
Difference between disagreement & conflict:
 Disagreement like “mini” conflict; based on personal,
cultural, logistical, or other differences
 Some disagreements grow into conflicts, but not all do
 Should address disagreements with potential for conflicts
before they actually become conflicts (Carroll, p. 126)
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Neither good or bad
Can be either constructive & creative (growth)
or destructive (destruction)
Natural & normal part of everyday life
Can be handled in positive or negative ways
◦ Can be a positive force for personal growth & social change
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Some level of conflict in an organization appear
desirable, although the optimum level for a specific
person or unit at a given time is difficult to determine
(Marquis & Huston, p. 489)
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Internal & external discord that results from differences in
ideas, values, or feelings between two or more people (Marquis &
Huston, p. 487)
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Because people have interpersonal relationships with others
having a variety of different values, beliefs, backgrounds, &
goals, conflict is an expected outcome
(Marquis & Huston, p. 487)
Personality
 Preferred communication style
 Whether a person prefers to engage in conflict or
avoid it
 Level of tolerance for multiple or competing
perspectives
 Partly due to inborn & learned traits
Training Skills
 Communication skills
(Carroll)
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We are all different and have different personalities. Our
differences can make a team strong and productive and/or present
challenges.
Some people are:
While others are:
Outgoing, talkative, spontaneous
Serious, quiet, introspective
Intuitive, shoot for the hip
Detailed, evaluate, ponder, and
Feeling and emotional
Logical and analytical
Concerned for people
Concerned for concepts
Structured, ordered, planned
Flexible, go with the flow, unplanned
(Team Building Inc.-2010)
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Ego. One’s ego can be a major cause of conflict. Our ego wants us
to be right and if we aren’t, then we tend to become very defensive.
Perhaps the quickest way to diffuse a conflict is to own your own
mistakes. (Carroll)
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When trust and faith between individuals has
been broken.
◦ When one puts faith and trust in another, and that
confidence is broken, it can create an emotional
response that elevates to conflict.
◦ When trust has been broken, the strongest emotion is
released and that often times leads to conflict
(Team Building Inc)
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When a disagreement has been left unresolved,
the emotions connected to the issue remain
strong and intact.
◦ An unresolved disagreement is often times put in the
“closet” but the emotions remain and these emotions
show their face at the next disagreement. Because the
emotions have remained, during the next conflict these
emotions are often times greater than need be.
(Team Building Inc)
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Poor communication that can lead unclear
expectations.
◦ Have you ever given clear instructions to a person only to
have those instructions misinterpreted?
◦ Perhaps you have given directions to someone and they
still did not comprehend the message.
◦ That can lead to frustration, which can be a major source
of conflict (McNamara, n.d.)
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Healthcare brings people of different ages, genders,
income levels, lifestyles, ethnic groups, educational
levels, & professions together for the purpose of
restoring or maintaining people’s health.
Differences of opinion over how to best accomplish
this goal are a normal part of working with people
of various skill levels & backgrounds.
Workplace itself, can be a generator of conflict
(Marquis & Huston, pp. 490-491)
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Competition between groups
Increased workload
Multiple role demands
Threats to professional identity & territory
Threats to safety & security
Scarce resources
Cultural differences
Invasion of personal space
(Whitehead, Weiss, & Tappen, p. 100)
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Competition between groups: Disagreements or
tension between over professional territory (may be
between physicians & nurses)
Increased workload: Emphasis on cost reduction &
increased pressure to get as much work as possible out of
each employee, sometimes more than employee can
realistically do (staff shortages)
Multiple role demands: Inappropriate task
assignments (asking nurses to mop floor & care for clients
too)-often for cost control efforts, but may lead to
disagreements about who does what task & who is
responsible for outcomes (Whitehead, Weiss, & Tappen, p. 100)
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Threats to Safety & Security: When roles are blurred,
cost saving is emphasized, & staff members face layoffs;
Peoples economic security is threatened
Scarce Resources: Inadequate money for pay raises,
equipment & supplies, or additional help can increase
competition between departments & individuals as they
scramble to grab their share of the little there is to distribute
(Whitehead, Weiss, & Tappen, p. 100)
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Cultural Differences: Different beliefs about
how hard a person should work, what constitutes
productivity, & even what it means to arrive at
work “on time”
Invasion of Personal Space: Crowded
conditions & constant interactions that occur at a
busy nurses’ station can increase interpersonal
tension & lead to battles over scarce workplace
(Whitehead, Weiss, & Tappen, p. 100)
There are five dimensions of conflict that are helpful in
conflict resolution and management. These are important
questions to ask oneself when dealing with situations and
one or more persons, groups, teams, units or departments
and organizations.
There are various types of conflict, factors that may influence
the development of conflict, resolution strategies, and
outcomes or results.
Remember as a person, respect of self and others, personal
attitude, and communication are key to one’s role in a
situation or event, in conflict development, resolution, and
outcomes. This is true no matter what the situation is, who is
involved, and what strategy is used to resolve it.
See the following slides for explanations of the dimensions,
influencing factors, and conflict resolution strategies.
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Qualitative Nature: Person can be totally overwhelmed in
one conflict situation yet handle several simultaneous
conflicts at a later time
Difference is in quality or significance of that conflict to the
person experiencing it
Although quantitative or qualitative conflicts produce
distress at the time they occur, they can lead to growth,
energy, & creativity by generating new ideas & solutions
(Marquis & Huston, p. 487)
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If handled inappropriately, quantitative or qualitative
conflicts can lead to demoralization, decreased motivation, &
lowered productivity
(Marquis & Huston, pp. 489-490)
1. Who or how many parties are involved?
2. What are the sources of conflict? What is it over?
3. Relationship between/among conflicting parties.
The type of relationship that exists between conflicting
parties will determine the intensity of the conflict.
4. How long has the conflict been in existence? If the
conflict has been lasting over a long period of time, it may
be more difficult to resolve.
5. The Process: How do we choose to deal with the conflict?
(Mertz & Lieber)
Who or how many parties (categories of Conflict) are
involved?
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Internal – Is the conflict within oneself? I value supporting
the corner grocery store but because their prices too higher, I
am going to shop at Cub or Rainbow.
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Interpersonal-Conflict between 2 or more individuals EX.
Your boss schedules you to work 3 week-ends in a row and
that is not acceptable to you
Intragroup-Conflict within a group. A group defined as 3 or
more people who share a specific role or identity
Ex. Conflict among nursing assistants on clients’ care team
Intergroup-Conflict between 2 or more groups.
Ex. Housekeeping department & dietary department
(Mertz & Lieber)
 Interpersonal
 Intrapersonal
 Intergroup
(Marquis & Huston)
Intrapersonal:
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Disturbance or conflict within a single individual
Internal struggles to clarify contradictory values or
wants
Example: An employee can experience internal conflict
about whether to stay in current position, which he likes,
or to move to another higher-level position which has a
much higher pay rate, but less flexible hours
Be self-aware & conscientiously work to resolve
intrapersonal conflict when first felt—essential to one’s
physical & mental health
(Marquis & Huston, pp. 490-491)
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Occurs between people, groups, or work teams
May involve disagreement about values or philosophy
Often due to differing or incompatible personalities or work
styles
Example: New hired employee begins to press for changing a
documentation system based on previous experience;
employees who are used to & comfortable with present system
do not see sufficient reason to change
(Marquis & Huston, pp. 490-491)
Interpersonal: “Horizontal violence” or “bullying”
between two or more people with differing values,
goals, & beliefs
 Significant issue confronting healthcare profession
(nurses & new graduates)
 If conflict not reported or
managed, consequences are
absenteeism & turnover
(Marquis & Huston, pp. 490-491)
Intra-group: Conflict within a group. A group can
be defined as 3 or more people who share a specific
role or identity
Intergroup: Conflict occurs between two or more
groups of people, departments, or organizations
 Example: Healthcare workers experience intergroup
conflict with family & work issues
◦ Healthcare workers experience more work interference with
family than conflict caused by family interfering with work
◦ Two political affiliations with widely differing or contradictory
beliefs
(Marquis & Huston, pp. 489-490)
What are the sources of conflict? What is it over?
 Resources-Are the people, or the groups, in conflict over
more staff assistance on a unit, equipment & supplies, [who
has right to sources?]
 Values-Conflict over beliefs, choices & perspectives, &
preferences; “What is important?” Occurs when people or
groups differ over beliefs, culture, cultural practices, etc.
Differing views for tasks or goals for providing care that
clients may reach positive outcomes
 Psychological Needs-Conflict over power & control &
emotional needs; This source of conflict deals with a
person(s) need for love, respect, safety, affirmation,
approval, friendship, power of one’s own fate
(Mertz & Lieber)
Relationship between/among conflicting parties. Type of
relationship that exists between conflicting parties will
determine the intensity of the conflict & the outcome.
 Know one another-How long have the parties involved in
the conflict known each another? Does the relationship
matter? Does the relationship matter to both or one of them?
How much?
 Climate-Do you trust or are you suspicious of the person that
you are in conflict with? Is the relationship emotionally tense
or calm, friendly or hostile, or open or resistant? Is one group
friendly with the other group or are they hostile towards one
another?
 Power-Do parties come to the conflict with equal power or a
power imbalance? Does any one party control the resources &
decision–making process?
(Mertz & Lieber)
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What is the degree of interdependence between the
conflicting parties? (In other words, do the actions of
one person or group seriously impact the others involved
in the conflict?)
◦ How often do the parties see or interact with one another?
◦ Is a positive relationship valued equally by both parties?
◦ Does each party need the cooperation of the other to achieve
important goals?
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How well do the parties know one another?
◦ Does it matter if conflicting parties come from different
cultures and know little about the other? (Mertz & Lieber)
How long has the conflict been in existence?
Conflict lasting over a long period of time may be
more difficult to resolve.
◦ Length-How long has the conflict continued? Are the
parties that first started the conflict still involved?
◦ Intensity-How emotional is the conflict? Could the conflict
end in a loss of a job, a marriage?
◦ Frequency-How often has the conflict reemerged? Are there
times conflict has escalated to severe levels? Did conflict
develop in stages?
◦ Perception-Do all the people involved in the conflict see it
as a conflict? Is the conflict seen as serious or irrelevant?
(Mertz & Lieber)
The Process: How do we choose to deal with the conflict?
 In every conflict, all parties involved make choices to take some
action they think will help them get what they want & need.
 Choices may be spontaneous or calculated, constructive or
destructive.
 Conflicts can develop in stages & consequently may involve many
different responses as the conflict proceeds.
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◦ Avoidance-Perhaps you choose to deny the conflict, ignore it, or back off.
◦ Diffuse-Postpone the conflict, wait.
Engage-Get involved in the conflict, work through & resolve the conflict.
◦ Direct Force or Competition
◦ Accommodation – to adapt or adjust
◦ Compromise
◦ Use Collaborative Problem-Solving
(Mertz & Lieber)
No Conflict
 Latent Conflict
 Perceived Conflict
 Felt Conflict
 Manifest Conflict
 Conflict Aftermath
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(Marquis & Huston, p. 492)
Latent conflict or "unstable peace,"
 Implies existence of antecedent conditions
 Conditions are ripe for conflict although no conflict has
actually occurred & none may ever occur
 Exists whenever individuals, groups, organizations, or
nations have differences that bother one or the other,
but those differences are not great enough to cause one
side to act to alter the situation
 Differential power, resources, differing interests or
values all have the potential to spark conflict if a
triggering event occurs
(Brahm)
Perceived Conflict or Substantive Conflict
 Intellectualized & often involves issues and roles
 Indicates cognitive awareness of stressful situation
 Exists when there is a cognitive awareness on the
part of at least one party that events have occurred
or that conditions exist favorable to creating overt
conflict.
 Groups recognizes that a conflict is emerging and
start to look for possible explanation
 Conflict can be resolved before it is internalized at
this stage
(Marquis & Huston, p. 492)
Felt Conflict or Affective Conflict:
 Occurs when conflict is emotionalized
 Presence of affective states such as stress, tensions, anxiety,
anger, hostility, fear, mistrust
 Organization, groups or individual become more internally
cohesive. Other group in the organization are viewed with
suspicion as outsider. “Us versus them” mentality begins to
really take hold
 Example: Person perceives conflict & does not feel it (No
emotion attached to conflict, but person views it only as a
problem to be solved) or
 Person may feel conflict but not perceive the problem
(Person is unable to identify cause of felt conflict)
(Marquis & Huston, p. 492)
Manifest conflict or Overt Conflict: Action is taken
& behavior results from the above three stages
 Action may be to withdraw, compete, debate, or seek
conflict resolution
 Conflicting parties are actively engaging in conflict
behavior which is usually very apparent to noninvolved parties;
 Feelings of conflict are now translated into actions &
words which could either be constructive obstructive to
problem solving process
(Marquis & Huston, p. 492)
Conflict Aftermath
 Either positive or negative
 If conflict well-managed: involved people believe
that their position was given a fair hearing
 If conflict poorly managed: Conflict issues remain &
return later to cause further conflict
(Marquis & Huston, p. 492)
Individuals are uncomfortable with or reluctant to address
conflict for many reasons
 Fear of retaliation
 Fear of ridicule
 Fear of alienating others
 Sense that one does not have a right to speak up
 Past negative experiences with conflict situations
People learn patterns of dealing with manifest conflict
early in their lives & family background, & experiences
often directly affect how conflict is dealt within
adulthood
(Marquis & Huston, p. 492)
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Generational Differences: Older people may have had
more experience with handling conflicts or may have a
particular strategy for dealing with them; there may also
be power & cultural issues that may play a role in the
generational differences
Gender Differences: Men more aggressive; women apt to try
to avoid conflict
Power: Single power concept of dominance with victory of one
side over another
Culture: “Nurses & other healthcare workers with diverse
cultural backgrounds bring to the workplace different conflict
behaviors that directly impact the outcomes of conflicts”
Action an individual takes to resolve conflict is often influenced
by culture, age power position, & up-bringing
(Marquis & Huston, p. 492)
People learn patterns of dealing with manifest conflict early in
their lives & family background, & experiences often directly
affect how conflict is dealt within adulthood
 Generational differences affect how individuals deal with
conflict too
 Gender may play a role in how one responds to conflict
◦ Traditionally, men are socialized to respond more aggressively
◦ Women are more apt to try to avoid conflicts or to pacify them
(Marquis & Huston, p. 492)
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Now that you know about many factors that may
influence conflicts, the next slides will present some
conflict resolution outcomes and strategies.
Strategies are not necessarily good or bad, however
there are advantages and disadvantages for each and
the one selected depends on the parties involved, the
situation, and the resources to resolve the issue, which
includes time.
As you read and study the slides, think of a time you
have seen the strategies in action. Consider the
outcomes. Was the strategy effective or ineffective and
why?
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Win–Win
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Win–Lose
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Lose–Lose
(Marquis & Huston, p. 492)
The optimal goal in resolving conflict is
creating a win–win solution for all involved
Winning & losing
are goals for
games,
not for conflicts
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Avoiding
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Compromising
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Competing
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Accommodating
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Collaborating
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Confronting
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Negotiating
Parties involved are aware of conflict, but choose not to
acknowledge it or attempt to resolve it
 May be indicated in trivial disagreements, when:
 Cost of dealing with conflict exceeds benefits of solving
it,
 Problem should be resolved by people other than you,
 One party is more powerful than the other, or
 Problem will resolve itself
(Marquis & Huston, p. 492)
Each party gives up something it as well as gets something
 Method used when both sides have a reasonable, important
goal & losing is not required
Advantages
 Effective for interpersonal conflicts
 Produces an “everybody” wins something scenario
 Efficient method when issues have higher importance & there
is limited time for resolution
Disadvantages
 Winning & losing exchanges are seen unfair & providing an
advantage to one side
 Conflict may resume if one side perceives that what it gave up
was more important than benefit received
 May not be as effective is one party is inherently less powerful
than other
(Carroll, p. 129)
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Method in which one side wins & other loses
 Sometimes called “forcing” – winner forces loser to accept
his/her perspective on the conflict
Advantages
 Useful if issue is critical or limited time to resolve issue
 Can help to move critical but unpopular decision quickly
through organization
Disadvantages
 Losers tend to resent losing
 Anger & resentment increase
 Losing side of agreement may be less willing to engage in
future conflicts or disagreements & may regularly adopt a
withdrawing or avoiding style
(Carroll, p. 129)
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Conflict resolution method called “smoothing” or “cooperating”
is used when a person ignores his/her own feelings about an
issue in order to agree with (accommodate) the other side
Advantages: If issue minor, accommodating allows parties to
move to issues of more importance
 One side accommodating on one issue can make other side
willing to accommodate on another issue
Disadvantages
 Can become power struggle: one trying to get other to give in
 More conflict rather than less can ensue if parties disagree
about importance of issues being accommodated
 Parties that consistently ignore feelings can wind up feeling
frustrated or used & maybe less willing to cooperate in future
(Carroll, p. 128-129)
Method: Both sides in conflict work to develop outcome
that’s best for both sides
 Emphasis on creative problem solving that meets each
side’s key goals
Advantages
 Seeks a permanent solution that achieves goals & objectives
 Creative & allows parties to develop new solutions, rather
than trading win/loss options
Disadvantages
 May requires significant resources, especially time
 Requires all parties commitment to success, possibly leaving
process open to interference by parties who do not want a
resolution to conflict
 All parties must have significant creative, critical thinking,
&problem-solving skills
(Carroll, p. 129)
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Method attempts to block conflict from start
 Very powerful method brings parties together, clarifies
issues & achieves outcomes
Advantages
 Prevents conflict from ever really developing
 Powerful & decisive; no ambiguity
Disadvantages
 Can make minor conflict seem much more important
than it is
 Does not allow positive aspects of conflict to develop
 Can create an organizational climate of conflict
intolerance
(Carroll, p. 130)
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Method –extension of compromise, with higher stakes
& more deliberate techniques to bargain for each side’s
give & take
Whether Win-Win, Win-Lose, or neutral (slit the
difference) situation depends on how much of a
relationship parties wish to continue after negotiations
are finished
(Carroll, pp. 129-130)
Advantage
 Useful for high stakes issues
 Solution usually seen as formal & more permanent than
compromise
 Does not require consensuses
 Conflicts tend to reoccur once negotiations are finished
Disadvantages
 Getting an agreement can be lengthy & involved
 Negotiations often seen as permanent, can be a problem if
one side decides they are unsatisfied with results
 Results may be less satisfactory if one side feels it has to
give up too much to negotiate for what it wins
(Carroll, pp. 129-130)
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Communication is no different than other areas of our lives.
In order to be successful in communicating with one
another we must practice communicating.
Our needs must be met during the communication process
in order for the process to be successful
Needs
1. Respect-treat people with respect
2. To be listened to
3. To be understood
4. To be loved & accepted
5. To be taken seriously
6. To move toward resolution
Respect: Put energy in being present for loved ones
instead of being distracted by difficulties with other
 The capacity to recognize & respond to the things
that matter to the other person
 Calm, non-defensive, & respectful reactions
 A readiness to forgive & forget, & to move past the
conflict without holding resentments or anger
 The ability to seek compromise & avoid punishing
 A belief that facing conflict head on is the best thing
for both sides (Segal & Smith)
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Nonverbal communication plays a big role in
conflict resolution
The most important information exchanged during
conflicts & arguments is often communicated
nonverbally.
Nonverbal communication is conveyed by
emotionally-driven facial expressions, posture,
gesture, pace, tone & intensity of voice.
The most important communication is
wordless
(McNamara, n.d.)
Nonverbal communication cues can play five roles:
 Repetition: they can repeat the message the person is
making verbally
 Contradiction: they can contradict a message the
individual is trying to convey
 Substitution: they can substitute for a verbal message. For
example, a person's eyes can often convey a far more vivid
message than words and often do
 Complementing: they may add to or complement a verbal
message. A boss who pats a person on the back in addition
to giving praise can increase the impact of the message
 Accenting: they may accent or underline a verbal message.
Pounding the table, for example, can underline a message
(McNamara, n.d.)
Tips for managing and resolving conflict :
Managing & resolving conflict requires ability to
quickly reduce stress & bring one’s emotions into
balance. One can ensure that the process is as
positive as possible by sticking to the following
conflict resolution guidelines:
Listen for what is felt as well as said. When we
listen we connect more deeply to our own needs &
emotions, & to those of other people. Listening in
this way also strengthens us, informs us, & makes it
easier for others to hear us (Segal & Smith)
Make conflict resolution the priority rather than
winning or "being Right". Maintaining &
strengthening the relationship, rather than
“winning” the argument, should always be your first
priority. Be respectful of the other person & his/her
viewpoint.
Focus on the present. If you’re holding on to old
hurts & resentments, your ability to see the reality of
the current situation will be impaired. Rather than
looking to the past & assigning blame, focus on
what you can do in the here-and-now to solve the
problem
(Segal & Smith)
Pick your battles. Conflicts can be draining, so it’s
important to consider whether the issue is really
worthy of your time & energy. Maybe you don't want to
surrender a parking space if you’ve been circling for 15
minutes. But if there are dozens of spots, arguing over a
single space isn’t worth it.
Be willing to forgive. Resolving conflict is impossible if
you’re unwilling or unable to forgive. Resolution lies in
releasing the urge to punish, which can never
compensate for our losses and only adds to our injury
by further depleting and draining our lives.
(Segal & Smith)
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Manage stress quickly while remaining alert and
calm. By staying calm, you can accurately read &
interpret verbal & nonverbal communication.
Know when to let something go. If you can’t come
to an agreement, agree to disagree. It takes two
people to keep an argument going. If a conflict is
going nowhere, you can choose to disengage & move
on
(Segal & Smith)
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Control your emotions and behavior. When
you’re in control of your emotions, you can
communicate your needs without threatening,
frightening, or punishing others.
Pay attention to the feelings being expressed as
well as the spoken words of others.
Be aware of and respectful of differences. By
avoiding disrespectful words & actions, you can
resolve the problem faster (Segal & Smith)
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The following slides are a presentation of
communication styles one of most important
factors in conflict management (communication).
In health care, assertive communication is
frequently used and is most effective, however all
styles are present. We all have used the styles
presented at one time or another.
Note the various styles and think about the ones you
use most frequently.
The following slides describe the communication
styles and provide some examples. Think of some
examples of each as you study the style.
Different Communication Styles
1.Assertive
2.Passive/Nonassertive or Submissive
3.Aggressive
4.Passive-Aggressive
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Promotes client safety by minimizing miscommunication
with healthcare team
People who use assertive communication are: Honest,
direct, & appropriate while being open to ideas & respecting
rights of others
Characteristic is use of “I” rather than “you” statements
“You’ statements-blame & put listener into defensive
position
“I” statements encourage discussion Nurse: “I am concerned
about….” to physician will gain attention of Dr. for benefit of
client. Important that Nurse be clear, concise, organized, &
fully informed when verbally presenting client concerns
(Berman et al., p. 482)
Includes standing up for your rights without infringing on
the rights of others.
 Assertive behavior results in an "I win; you win" outcome.
 Assertion involves expressing beliefs, feelings &
preferences in a way which is direct, honest, appropriate
& shows a high degree of respect for yourself & for others.
 "When you talk, I can't hear the movie. Please keep it
down."
 "I really like it when you wear that shirt. You look great!"
 Assertiveness Script: "When you __(behavior)__ , I feel/ I
think ________ ; So, I would like __(new behavior)____ .“
(Johnston)
You typically get off from work at 4:30PM.
One day your boss comes up to you at 3:30PM and
says, “Oh, by the way, you need to stay at work
today until 6:00PM.”
You have other activities planned to do after work,
so staying late is an imposition.
What would be different ways you could respond to
your boss?
Practice using some assertive communication.
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With this style, people allow their rights to be violated by
others; give up their own rights (directly or indirectly) &
defer to the rights of another person
Meet the demands & requests of others without regard to
their own feelings & needs as they believe their own
feelings are unimportant
"I lose; you win" outcome; Usually avoid confrontation
(Berman et al., p. 482)


Violates one’s own rights through inaction or by
failing to express one’s thoughts, feelings or
desires
Some experts believe that people who use this
style are insecure & try to maintain their selfesteem by avoiding conflict (avoiding negative
criticism & disagreement from others)
(Berman et al., p. 482)
Example: "We can do whatever you want. Your ideas are
probably better."

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

Person strongly asserts legitimate rights & opinions with little
regard or respect for others ideas or opinions
Often perceived as personal attack by other person because
aggressive communication humiliates, dominates, controls,
or embarrasses other person
By lowering other person’s self-esteem, aggressive person may
feel superior which helps to increase his/her self-esteem
Can take several forms: screaming, sarcasm, rudeness,
belittling jokes, & personal insults
"I win; you lose" outcome; Overbearing, demanding,
competitive, & forceful
Example: "Hey, I'm in a hurry. Get out of my way."
(Berman et al., pp. 482-483)
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Passive-aggressive behavior is a pattern of expressing
negative feelings in an indirect way — instead of
openly addressing them
Appear to agree with the requests of others; may
seem enthusiastic about them, but they don't
perform a requested action on time or in a useful
way, and may even work against it.
Use nonverbal behavior to express anger or
resentment that they can't express verbally.
An indirect attempt to control or punish others
(Hall-Flavin)
Example - You say:
“Oh, OK, I’ll stay. I need to change a lot of plans and people
will probably be really mad at me, but that’s OK - don’t
worry about me. I guess what I had planned isn’t that
important. I don’t mind - really (deep sigh). I hope my
friends will still talk with me after canceling at the last
minute.”
Example: "I’m sorry I'm so late. I didn’t realize this was such
a big deal."
Example: "Oh, don’t bother, I'll just have to do it myself."
Example: Showing up very late to a meeting that one didn't
really want to attend and then making up excuses for the
lateness that deflects attention from the real reason one
was late
(Hall-Flavin)
Berman, A., Snyder, S.J., Kozier, B., & Erb, G. (2008). Communicating. In A.
Berman, S.J. Snyder, B. Kozier, & G. Erb (Eds.). Kozier & Erb’s
Fundamentals of nursing: Concepts, process, and practice (8th ed.) (pp.
459-85). Upper Saddle River, NJ: Prentice Hall
Brahm, E. (2003, September). Latent conflict stage. Retrieved from
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Carroll, P. (2006). Nursing leadership and management: A practical guide.
Clifton Park, NY: Thompson Delmar Learning
Hall-Flavin, D.K. (2009, April 8). Signs & symptoms of passive-aggressive
behavior. Retrieved from http://www.mayoclinic.com/health/passiveaggressive-behavior/AN01563
Marquis, B.L. & Huston, C.J. (2009). Managing conflict. In B.L. Marquis &
C.J. Huston (Eds.). Leadership roles and management functions in nursing:
Theory and application (6th ed.) (pp. 487-512). Philadelphia, PA: Wolters
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Mertz,G. & Lieber, C.M. (2004). Education for social responsibility:
Five dimensions of conflict. Retrieved from
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ons%20-%20high%20school/ESR_Five_Dimensions.pdf
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resolving conflicts. Retrieved from
http://helpguide.org/mental/eq8_conflict_resolution.htm
Sullivan, E.J. & Decker, P.J. (2001). Effective leadership and
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Team conflict. Retrieved from
http://www.teambuildinginc.com/tps/031b4.htm
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